Condition after left cytoreductive nephrectomy Dated August, 2019. Condition during therapy with sunitinib since September, 2019.
Complications: pathological right femur fructure on August 9, 19. Condition after surgical treatment on August 30, 19 (closed repository, immobilization of the right hip fracture with an external fixation device). Condition during the therapy (sunitinib 50 mg daily + denosumab 120 mg s/c once every 28 days + photodynamic therapy since 05.06.2020). Second clinic group. ICD-10 C64.Histological examination: surgical sample (kidney) (689403), No.6207 of August 9, 19. Result – light cell renal cell carcinoma of kidney, G4, grows though the capsule, paraaortic lymph nodes without tumour. Radioisotope examination: whole-body osteoscintigraphy dated July 16, 2019. Whole body scintigraphs in the anterior and posterior projections show intense inclusion of the medication into bone structures. Distribution of the radiopharmaceutical corresponds to the age norm. There are foci on intensive pathological hyperfixation of the radiopharmaceutical in the projection of the anterior segment of the seventh right rib, middle and upper third of diaphysis of the right femur. In other bones, distinct foci of pathological accumulations of the radiopharmaceutical, which are typical for the specific pathological process, were not reliably revealed. Distribution of the radiopharmaceutical in the parenchyma of the left kidney is focally uneven. Taking into account the information from the anamnesis – C-r of the left kidney. Residual radioactivity in the right kidney and the urinary tract corresponds to the time of the scanning. There is no atypical fixation of the medicine in parenchymal organs or soft tissues.
Conclusion: scintigraphical signs of the secondary damage of the front part of the seventh right rib, right femur. MSCT of abdominal, chest organs and organs of retroperitoneal space with i/v contrast dated July 16, 2017.
Conclusion: MTS in the seventh right rib. Mts in S8S10 lower part of the left lung and in S4 middle part of the right lung. Small single subpleural foci in both lungs. Chronic deforming bronchitis. Bilateral basal and apical pneumosclerosis. Post-inflammatory changes in the upper segment of the left lung. Malignant formation in the left kidney. Simple cysts of the left kidney. Single simple cysts of the right part of the liver. Chronic cholecystopancreatitis. MSCT of chest organs with i/v contrast dated January 9, 2020.
Conclusion: Multiple mts of both lungs. Positive dynamics in comparison to previous CT data (decrease in the sizes of lung foci, new mts at the screening were not found). Condition after the resection of the anterior segment of the seventh right rib. The patient had a consultation in SBHOVR "Regional Clinical Oncology Hospital" in Vladimir.
Recommended therapy: sunitinib 50 mg daily for 4 weeks/2 weeks with the break till progression or votrient 800 mg daily till progression + denosumab 120 mg s/c once every 28 days for 12 months. The patient does not get medications under the Supplementary Medicines Provision (DLO and RLO).
The medical commission took place. It was decided to choose the treatment (sunitinib 50 mg daily for 4 weeks/2 weeks with the break untill progression; denosumab 120 mg s/c once every 28 days for 12 months). CT of chest organs with IV bolus contrast dated August 4, 20.
Conclusion: Focal changes (mts) of both lungs dated May 15, 2020. – without negative dynamics, some decrease of foci sizes in C8 of the left lung is noticeable, new foci are not revealed. Osteolytic mts in the anterior segment of the seventh right rib (without visible dynamics since May 15, 2020). Chronic deforming bronchitis. Fibrous changes in C1/2 of the left lung. S-shaped scoliosis of the spine at the screening. Radioisotope screening: whole body osteoscintigraphy of September 18, 2020 Intensive inclusion of the medicine into bone structures is seenin the anterior and posterior projections in the scintigrams of the whole body. Radiopharmaceutical distribution corresponds to the age norm. The patient is under supervision since 2019, the second screening in total. Comparing with the previous scanning dated July 16, 2019 – scintigraphic image of the radiopharmaceutical distribution has positive dynamics: inclusion of medicine in previously revealed centres decreased (in the projection of the anterior part of the seventh right rib, right femur). New foci were not reliably revealed. The only functioning right kidney was visualized. Residual radioactivity in the kidney corresponds to the time of the scanning. There is no atypical fixation of the medicine in parenchymal organs or soft tissues. Ultrasound of kidneys, the bladder, prostate dated January 21, 2021.
Conclusion: ECHO-image after left-sided nephrectomy. Ultrasound on abdominal organs dated January 27, 21.
Conclusion: ECHO-image of calculous cholecystitis.
To get a consultation/hospitalization in OOO “Onkoklinika” you should go to the clinic residence (oncology clinic) at the place of your and take a reference (057-U) with the signature of your treating doctor and the seal of the medical organization.
The manager contacts patients just after the concilium of doctors (every Thursday) where the specialists look through all the documents and make a decision about the necessary treatment.